scholarly journals Post-operative Pain Outcomes of Laparoscopic Ventral Hernia Repair (LVHR): An eight-year experience

2021 ◽  
Vol 11 (4) ◽  
pp. 148-152
Author(s):  
Shahid Rasul ◽  
Hassan Ahmed ◽  
Sanum Ali ◽  
Surrendar Dawani ◽  
Sarah Zahid ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Total N ◽  
Patient Demographics ◽  
National Medical ◽  
Post Operative Pain ◽  
Pain Outcomes ◽  
Superior Approach ◽  
Absorbable Tacks

Objective:To evaluate post-operative pain, recovery time and standard of living in patients undergoing LVHR in detail. Study design and Setting: This prospective cohort study was conducted at a tertiary care hospital of Karachi, Pakistan,after getting approval from the “National Medical Centre EthicalReview Board”, from January 2011 to December 2019, Methodology: Total n= 577 patients undergoing standard LVHR procedure (defect closed with non-absorbable monofilamentsuture, reinforced with intra-abdominal dual layer mesh, anchored with non-absorbable tacks & sutures). Patient demographics,perioperative & postoperative findings and post-operative pain analysis were investigated and presented as descriptivestatistics. Follow-up was carried out at 1stweek, 2ndweek, 3rdmonthly, 6 monthly and 12 monthly post-operative appointments. Results: During the study period of nine years (January 2011 to December 2019), 577 patients (primary ventral hernia n=232, recurrent ventral hernian=188 patients, incisional hernian=157) underwent LVHR. Mean post-operative hospitalstay was 1.53 ± 1.8 days. Mean post-operative pain assessment onvisual analog scale (VAS) after surgery (0-3days) wasreported to be 38.5±29 by 65 patients out of 577 (11.26%), which significantly decreased at the end of 1st week to 27.9 ± 25.6. Only 3 patients (0.51%) reported chronic pain during the span of 3-6 months. Conclusion: LVHR was associated with considerably less post-operative pain, shorter hospital stay and reduced time of convalescence. It is demonstrated that LVHR to be a safe and superior approach for the repair ventral hernias

scholarly journals A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana

2021 ◽  
Author(s):  
Amit Kumar ◽  
Surender Kumar ◽  
Anand Krishnan ◽  
Manish Verma ◽  
Uma Garg ◽  
...  
Keyword(s):  
Operative Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Care Hospital ◽  
Secondary Complications ◽  
Post Operative Pain ◽  
Secondary Bleeding ◽  
Paediatric Age ◽  
Cold Dissection

AbstractTonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.

scholarly journals Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
National Medical College ◽  
Medical College ◽  
National Medical

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52

scholarly journals Intraperitoneal Onlay Mesh in Ventral Hernia Repair – Experience in A Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 7 (2) ◽  
pp. 106-109
Author(s):  
Md Ezharul Haque Ratan ◽  
Hasina Alam
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Intraperitoneal Onlay Mesh ◽  
Diabetes Status ◽  
Onlay Mesh

Background: Ventral hernias are common problem in surgical practice. Repair of hernia by a prosthetic mesh is a well recognized procedure. But whether the procedure is to be done by open or laparoscopic technique is still a topic of discussion. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia in our country. We are evaluating the usefulness of this procedure as routine operation for ventral hernias.Methods: All patients attending at Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic disorders (BIRDEM) outpatient department (OPD) with ventral hernia were approached and counseled for laparoscopic IPOM, but only those who agreed were included in this study. Fifty consecutive patients underwent IPOM by a single surgeon. Preoperative evaluation was done rationally and surgery performed by standard laparoscopic method. Age, sex, diabetes status and additional procedures done were evaluated. Post- operative follow up period was from 3 months to 75 months and any complication or recurrence were noted.Results: We are reporting 50 cases of laparoscopic IPOM, over a time period of 78 months (April 2010- September 2016). Eleven cases were male, 39 female (M: F=1:3.5). 35 (70%) cases were diabetic, 15 (30%) were non-diabetic. Mean age of the patients were 47.7yrs (male 47.7+9.5 yrs, female 47.7- 2.6 yrs, diabetic patients 47.7+ 2.5yrs, non-diabetic patients 47.7-5.9yrs). Indication for IPOM was paraumbilical hernia 29 cases (58%), incisional hernia 14 cases(28%), multiple incisional hernia 2 cases ( 2 large defect in one case, 5 defects of varying size in another patient), umbilical port hernia 2 cases, paraumbilical along with incisional hernia 1 case, epigastric hernia 1 case, lumber hernia 1 case. In 48 cases (96%) polypropylene mesh and only in 2 cases (4%) dual mesh were used. In addition to IPOM procedure, in same sitting laparoscopic cholecystectomy was done in 8 cases, Dilatation & Curettage in 1 case and adhesiolysis in 7 cases. None of the case required conversion to open, neither was there any intra-operative complication. In one case there was recurrence . In another case there was false recurrence due to development of ascites. Four patients developed seroma which were managed conservatively.Conclusion: Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty has proved to be an effective surgical procedure for ventral hernia repair. It provides much benefits with low complications and conversion in experienced hands.Birdem Med J 2017; 7(2): 106-109

A STUDY ON ASSESSMENT OF RISK FACTORS, COMPLICATIONS AND QUALITY OF LIFE OF PATIENTS WITH HYPOTHYROIDISM IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 38-40
Author(s):  
CH. Sridev ◽  
Samhitha Karnati ◽  
Likhitha Madari ◽  
Liyaqath Ali ◽  
Raviteja Nethula
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Total N ◽  
Sf 36 ◽  
High Bmi

Background: Hypothyroidism is a syndrome which results from decreased production of thyroid hormones from thyroid gland and hence it can also be termed as underactive thyroid disease. Objectives: To assess the quality of life in patients with denovo hypothyroidism. To assess risk factors, complications in patients with hypothyroidism. Materials and methods: There was a total (N=100) number of participants enrolled in the study and are evaluated for risk factors and complications and among 100, 40 patients are Denovo hypothyroid who are assessed for quality of life. This is a prospective observational study in which the risk factors, complications and quality of life of patients is evaluated for those patients who are willing to give informed consent and meet the inclusion criteria. Results and Discussion: Referring to the ndings, the patients with high BMI, females and age around 20-30 are more prevalent. Patients who do not adhere to medications develop complications such as goiter and cvs problems but mostly obesity is seen and QOL of patients was studied using SF-36 and HADS scales. The initial mean was found to be less compared to the nal mean in SF-36 whereas in HADS the initial mean is high compared to the nal mean. The Patient's BMI was high initially and then reduced to normal.This implies that after educating the patient about the disease and need of medication the nal result shows there is improvement in the patient's QOL. P values of SF 36 and HADS are 0.0001 and 0.0314 respectively, which by conventional criteria was found to be statistically signicant. Conclusion: This study simply showed that the females, patients with high BMI and age around 20-30 are the major risk factors. Proper patient education, care and medication adherence are the cornerstones to help avoid complications and improve patients quality of life.

scholarly journals Evaluation of postoperative pain in closure versus non-closure of parietal peritoneum at caesarean section

2017 ◽  
Vol 6 (5) ◽  
pp. 1969
Author(s):  
Avantika Sharma ◽  
Nupur Hooja ◽  
Apoorv Shastri ◽  
Brijesh Dadhich ◽  
Richa Manish
Keyword(s):  
Postoperative Pain ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Parietal Peritoneum ◽  
P Value ◽  
Care Hospital ◽  
Post Operative Pain ◽  
Background Pain ◽  
One Year ◽  
Closure Group

Background: Pain is one of the major discomfort which drives post caesarean mothers to seek help. Thus, it is important to know if any change in surgical technique could have effect on the post-operative pain which affects all the woman’s activities. Hence, the study was undertaken to study the effect of closure and non-closure of parietal peritoneum on postoperative pain.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Detailed history, investigations, operative details, postoperative outcome in terms of pain were recorded and analysed.Results: Women in the closure group had more postoperative pain. P value was highly significant at 8h (P=0.0001), 16h (P=0.0001), 24h (P=0.00001) and 32h (P=0.000001), 40 hour (P=0.00001) and 48h (P=0.0001).Conclusions: Peritoneal should not be closed routinely in caesarean sections as it is shown to cause less postoperative pain.

scholarly journals Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

2020 ◽  
Vol 27 (02) ◽  
pp. 335-340
Author(s):  
Salman Azhar ◽  
Muhmmad Wasif Baig ◽  
Shahid Rasool ◽  
Rizwan Rasool Khan ◽  
Talha Munir ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
E Coli ◽  
Patient Demographics ◽  
Tract Infections

Urinary tract infections (UTIs) are a major burden to the health care as it is estimated that around 150 million UTIs occur yearly worldwide. Enterobacteriaceae are the most common agent causing serious urinary tract infections; and MDR cases are increasing day by day. Objectives: To determine the frequency and patient demographics of multidrug resistant urinary tract isolates of Escherichia Coli in a Tertiary Care Hospital. Study Design: Retrospective cross sectional study. Setting: Medicine Department of Madinah Teaching Hospital / The University of Faisalabad, Faisalabad. Period: From May 2016 to Sep 2018. Material & Methods: 187 patients of age 15 to 90 years with positive E. coli on urine culture and sensitivity were included in this Retrospective cross sectional study. All those patients with history of dysuria (pain during urination) or frequent urination (more than 7 times per day) were advised urine complete analysis and those with >5 WBCs or pus cells /HPF or having positive for leukocyte esterase and/or nitrite, were advised urine culture and sensitivity. Main outcome variable was the frequency of MDRE cases among the culture positive E. coli UTI patients. Results: Among all the cases of E. coli UTI, frequency of MDRE UTI was 66.8% (n=125) and rest 33.2% (n= 62) cases were not MDR UTI. 97.3% patients were resistant to lactam antibiotics, 95.7% were resistant to quinolones and 68.4% were resistant to aminoglycosides.

scholarly journals Determinants, characteristics and treatment of neck pain in a tertiary care hospital in Kerala

2016 ◽  
Vol 6 (1) ◽  
pp. 150 ◽  
Author(s):  
Liya Roslin Joseph
Keyword(s):  
Neck Pain ◽  
Tertiary Care ◽  
Muscle Relaxants ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Physical Medicine ◽  
Neck Stiffness ◽  
X Ray ◽  
Patient Demographics ◽  
Study Population

Background: This study was undertaken to study the determinants, clinical characteristics and treatment pattern of neck pain in patients attending outpatient department of Physical medicine and Rehabilitation in a tertiary care hospital.Methods: Study comprehended single patient visit. Data regarding patient demographics, characteristics of neck pain and clinical diagnosis, drugs prescribed to each patient were recorded in a pre prepared proforma. Clinician’s opinion about patient’s X-ray of cervical spine and the data regarding alternative treatment modalities were also noted. Data analysis was done with the help of excel 2007 and SPSS 16 statistical software.Results: Among 170 patients included in the study 38.8% of patients were in the age group of 40-49 years with M:F ratio-1:2.9. 98.8% of patients experienced radiation of neck pain to one or both arms. Neck pain also was associated with numbness in arm (82.4%), forearm (61.8%) or hand (59.4%) and neck stiffness (99.4%). Half of the study population were found to have neurological deficit. 98.2% of patients had positive radiological evidence for neck pain. Cervical spondylosis (85.9%) was the most commonly observed cause for neck pain. All patients received pharmacotherapy with NSAIDS and muscle relaxants. Diclofenac was the most commonly prescribed NSAID. 45% of the patients received alternative and complementary treatments for neck pain.Conclusions: NSAIDs and central skeletal muscle relaxants are the commonly prescribed medications and alternative treatments like spinal manipulation and physiotherapy appears to be beneficial in patients with neck pain.

scholarly journals A comparative study between manual vacuum aspiration and electronic suction for surgical treatment of abortion

2021 ◽  
Vol 10 (9) ◽  
pp. 3342
Author(s):  
Gira C. Dabhi ◽  
Twinkle S. Patel ◽  
Nimisha J. Chaudhary ◽  
Janki M. Pandya
Keyword(s):  
Hospital Stay ◽  
Success Rate ◽  
Pain Perception ◽  
Tertiary Care ◽  
Uterine Perforation ◽  
Care Hospital ◽  
Trimester Abortion ◽  
Vacuum Aspiration ◽  
Post Operative Pain ◽  
Manual Vacuum Aspiration

Background: Present study is done to study the safety, efficacy and complications of using manual vacuum aspiration (MVA) for surgical management of first trimester abortion in comparison to electronic suction.Methods: It is a retrospective observational study conducted in department of obstetrics and gynecology at tertiary care hospital. Out of 100 cases taken, 50 abortions were terminated by MVA and 50 were terminated by electric suction/vacuum aspiration (EVA).Results: In this study, majority of the patients were primigravida (60%). Most of the patients had period of gestation between 7 to 9 weeks (40%) followed by up to 6 weeks (33%) in both groups. Time taken for the procedure was less in MVA (5-9 min.) than electronic suction (7-11 min.). In terms of complications, blood loss ≥100 ml was more with EVA (18%) compared to MVA (6%). Uterine perforation was seen with EVA (4%) and none with MVA. As far as success rate is concerned, EVA got 98% while MVA got 90%. Post-operative hospital stay was less with MVA (≤12 hours) than EVA (up to 24 hours). Post-operative pain perception was less with MVA (18% severe pain) while with EVA, 36% with severe pain.Conclusions: Both the evacuation techniques are almost equally effective and safe, still duration; post-operative pain and hospital stay are less with MVA. Success rate is better with EVA.

scholarly journals Eclampsia at a tertiary care hospital of Nepal: A five year study

2018 ◽  
Vol 6 (2) ◽  
pp. 14-21
Author(s):  
Shraddha Rana ◽  
Pramod Kattel
Keyword(s):  
Blood Pressure ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Mortality ◽  
Care Hospital ◽  
Cross Sectional ◽  
National Medical

Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

scholarly journals Awareness and Community Response To Stroke Signs and Symptoms Following the National ‘Act Fast’ Campaign in An Ethnically Diverse Population

2021 ◽  
Author(s):  
Zain A. Bhutta ◽  
Sameer A. Pathan ◽  
Tuukka Puolakka ◽  
Naveed Akhtar ◽  
Stephen H. Thomas ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Signs And Symptoms ◽  
Community Response ◽  
Stroke Onset ◽  
Care Hospital ◽  
Stroke Patients ◽  
Convenience Sample ◽  
Total N ◽  
Female Ratio ◽  
Study Population

Abstract Background Evaluation of public education stroke campaigns and behavioral studies to assess emergency response at stroke onset are scarce. We aimed to assess patient’s and bystanders’ foreknowledge of stroke signs and symptoms and their response at stroke onset. We also enquired if ‘Act FAST’ stroke campaign in Qatar contributed to their foreknowledge. Methods In Qatar, the first national stroke awareness campaign, ‘Act FAST’, was launched in May 2015. The study population included a convenience sample of stroke patients admitted to the stroke service in Qatar’s largest tertiary care hospital from November 2015-February 2016. We interviewed patients with acute onset stroke admitted to the stroke unit using a validated questionnaire. If the patient had disabling stroke, we interviewed relatives/bystanders present at stroke onset. The primary outcome was the correct response of calling Emergency Medical Services (EMS), recognizing the possibility of stroke. Results The questionnaire was administered to 165 participants, 142 (86.1%) stroke patients, and 23 (13.9%) bystanders. The mean age of the study population was 52.6 (SD = 11.7), and sex (male-female) ratio was 7:1. Ethnic categories were South-Asian (n = 101, 62.2%), Middle-Eastern (n = 14, 8.5%), Far-Eastern (n = 26, 15.8%), African (n = 16, 9.7%) and Others (n = 8, 4.9%). From the study group, 33 (20.1%) participants had foreknowledge of stroke signs and symptoms, and of these, 27 (16.5%) knew about the Act FAST campaign in Qatar. The behavioral responses of the participants (total n = 165) on stroke onset included; immediately activated EMS (n = 55, 33.3%), called friends/relatives (n = 69, 41.8%), drove to hospital (n = 33, 20%), decided to rest and waited for improvement in condition (n = 21, 12.7%), and 12 (7.3%) responded as none of the above. Of the participants who admitted having watched the Act FAST campaign, 92.6% (25/27) reported that the campaign affected their response to stroke onset. There was no association of ethnicity, marital status or FAST campaign awareness with behavioral response of EMS activation on stroke onset. Conclusions The foreknowledge of stroke signs and symptoms and the Act FAST campaign was low in the community. However, seeking help by activating EMS at stroke onset was generally high in the study population irrespective of the awareness to the campaign.

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